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Collins RM Jr, Zielke HR, Woody RC: Valproate increases glutaminase and decreases glutamine synthetase activities in primary cultures of rat brain astrocytes

A 2019 systematic review of five placebo-controlled trials conducted by one group of investigators examined the effect of acetyl-L-carnitine (ALCAR) in 398 participants with cirrhosis and portal hypertension (high blood pressure in the portal vein) and presenting with either subclinical or overt hepatic encephalopathy

The team additionally observed that there were especially low levels of the substance in those with the most severe symptoms, and that levels were also lower amongst those patients who had reported a childhood history of abuse, neglect, poverty, or exposure to violence